Prolonged graft survival by donor-specific blood transfusion (DSBT).
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Biomedical subjects
Publications and source records attributed to T Inou.
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A 48-year-old man developed severe chest pain and became unconscious. Coronary cineangiography revealed single coronary artery of the type L2b by Sharbaugh and White. Ergonovine, 0.2 mg i.v., produced coronary arterial spasm in the right coronary artery. This case suggests that coronary arterial spasm might be a cause of sudden death in patients with single coronary artery. However, an association of single coronary artery and coronary arterial spasm might be coincidental.
Epstein-Barr virus (EBV)-induced lymphoblastoid cell lines (LCL) were established from seropositive adult Japanese donors. HLA-A, -B, -C and -DR antigens expressed on these EBV-LCL cells were identical to those of peripheral blood lymphocytes. There were no extra reactions upon DR typing; the extra reactivity in A, B and C typing was due to contaminating DR antibodies in the typing sera. In one-way mixed lymphocyte reactions with a stimulator : responder ratio between 1 : 10 and 1 : 20, autologous EBV-LCL exhibited low stimulation which could be distinguished from that of unrelated combinations. EBV-LCL may be useful for the screening of anti-DR antisera and as targets in cell-mediated lympholysis. Furthermore, EBV-LCL established from homozygous typing cells may be useful in HLA-D typing.
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The effect of HLA-DR matching between living kidney donors and related recipients on 1-year graft survival was examined in 35 transplant recipients excluding 2-haplotype identical siblings. All 11 DR-compatible grafts survived 1 year; 7 of 24 DR-incompatible grafts ceased to function within 1 year (p less than 0.05). Among 24 DR-incompatible recipients, 6 of 11 who had preoperatively been transfused with less than 1000 ml blood lost their graft function. On the other hand, 12 of 13 who had received at least 1200 ml blood maintained their graft function beyond 1 year (p less than 0.05). All DR-compatible recipients received pretransplant blood transfusions and all produced anti-DR antibodies against random panel B cells after transplantation, but not against the graft donor's B lymphocytes. The anti-DR antibodies disappeared within 3 months. In recipients whose sera broadly reacted to random panel B cells at 1 years after transplantation, only 4 of 10 grafts survived. In recipients whose sera had lost their anti-DR reactivity within 1 year, all 20 grafts survived (p less than 0.05).
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Clinical effects of bredinin were evaluated in 18 renal transplant patients. Of 12 cases in which administration of azathioprine was suspended due to liver dysfunction and leucopenia, treatment with bredinin resulted in amelioration of these symptoms without harm to the transplanted kidneys in 10 cases. In six other cases, bredinin was used from the time of renal transplantation, and the postoperative course in four of these cases was uneventful, enabling these patients to return to society. The remaining two patients have had to undergo haemodialysis again as their transplanted kidneys failed to function and they showed severe stomatitis in the early postoperative period. The results of clinical use of bredinin in renal transplant patients suggest that this drug is an effective immunosuppressive agent which is without the drawbacks seen with azathioprine. Nonetheless, one must bear in mind that the function of the transplanted kidney should be evaluated carefully before using this drug.
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Anti-HLA-A, B, C and DR antibodies in 173 sera derived form renal transplant recipients were examined, using the cytotoxicity techniques standardized at the 8th International Histocompatibility Workshop. About 50% of sera obtained within 6 months of transplantation showed anti-HLA-DR antibodies. Thereafter, serum anti-DR antibodies were found in about 30% of the examined sera. However, at more than 3 years after transplantation, the reappearance of anti-DR antibodies was noted in more than 60% of the examined sera. Anti-HLA-A, B and C antibodies were not found except in the sera from recipients with irreversible rejection. The post-transplant production of anti-DR antibodies against incompatible donor HLA-DR antigens was confirmed in sera derived repeatedly from the same patients.
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A simple, compact and light weight design for a machine to perform plasma exchange or haemofiltration at a desired place is required. Based on these considerations, we have designed and fabricated a portable machine having a unique volume balancing mechanism and evaluated the in vitro and in vivo fluid balancing performances. We have obtained fully acceptable results during the evaluations and have performed clinical tests with favourable results.
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Sera of 58 recipients of renal allografts were studied for the presence of antibodies against cell cultures of human B lymphoid cell lines (B-LCL) and bovine erythrocytes (BRBC). Cytotoxic anti-B-LCL antibodies were found in 13% of the sera from recipients with the grafts and in 67% of the sera obtained after removal of the rejected grafts. Most of these sera also contained BRBC lysins of high titers. Absorption studies showed that the anti-B-LCL antibodies are directed against antigens shared by BRBC and that they can be absorbed with corresponding graft tissues. The specificity of BRBC lysins found in some of the transplantation sera was shown to be similar to that of Hanutziu-Deicher antibodies.
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